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HomeMy WebLinkAboutHOOD REP .8/24/2012PHOENIX FIRE PROTECTION PAY FROM THIS INVOICE 210 South Cotta Court Visalia, CA 93292 TEL: (559) 622 -8969 FAX: (559) 622 -9023 LIC # C16- 779030 Name Parts & Materials P" ire °rr Fuse Links Y W Address asC,,QQ. IC City M, te- F J State r 6 Zip L Cash Authorized B jt0 Wet Chemical Check# Phone Cell Fax Z71, 6063 Visa or Mastercard Email Auth # Description o Parts & Materials P" ire °rr Fuse Links Y W Carbon Dioxide IC Wet Chemical Y4 4, G, Dry Chemical Hydrostatic Testin& Description o Parts & Materials P" ire °rr Fuse Links III Blow 4ff Caps/Seals Hydrostatic Testi Pressurized 1 Fire Extin6uisher Size Credit Surcharge d System Report System Description Date of ervice 88 Time A.M. P.M. k P, .Q Annual S mi- Annual Recharge Install Renovation Location of System Cylinder Size Slave f- / 10-(, ',A 31 5 Cylinder Size Fuset_inksMbF Fuse Links 450F Fusc Links 500F Other Fuel Shut -Off Electric Gas Size Manufacturer Model Number Wet Dry Production Date Hydro Date Last Serviced 0, ow P ON Serviced By: 0 a ea Item Inspected PullStation ........................... ............................... Gas Valve / Electrical Cut off .. ..............................,{( Nozzle Location/Appliance Coverage ................. LC7' TankHydro ........................... ............................... Tank..................................... ............................... ControlHead ........................ ............................... r !r Braketing .......................... _% . . ................. u Fuse Links - Replaced or Gleaned! .................. a- Systems Installed to Mfctr's Recommendations.. E 1" Fdter ..................................... ............................... Failures & Recommendations: r ' ©' F1 El i Exhaust Fan .......................... ............................... y /6 Make up Air .......................... ............................... [I' El 1:1 r` i! g l/ Q UL 300 .................................. ............................... f-3) Filters - Baffle Style .............. ............................... K- Class ................................. ............................... 1 e T aC D i ff 9 " ( w Detection Line ...................... ............................... Et V lamSystemMonitoredBy: Yes No , The signature below assures that the above stated services have been rendered accordingly. I have PH # been given authority to allow and approve payment for such required services by the establishment which has received this service and hereby authorized payment for all services rendered. Hood & Duct ........................ ............................... Other..................................... ............................... of eServiceserformedriorto30daY• xnir tinn Ot her ..................................... ............................... 1:1 E] El SPP Signature Nozzle 4M Links Hood Size Date' Payment due upon completion. Pd d 10- 6F t G Type Appl _ '/Type Appl Type Appl Type Appl Type Appl Distance Distance Distance Distance Distance Nozzle V Nozzle ? R .) t rNozzle 0't r-), 0,. ozzle Nozzle _ Type App] Distance Nozzle Parts & Materials P" ire °rr Fuse Links Blow 4ff Caps/Seals 1yy'F d System Report System Description Date of ervice 88 Time A.M. P.M. k P, .Q Annual S mi- Annual Recharge Install Renovation Location of System Cylinder Size Slave f- / 10-(, ',A 31 5 Cylinder Size Fuset_inksMbF Fuse Links 450F Fusc Links 500F Other Fuel Shut -Off Electric Gas Size Manufacturer Model Number Wet Dry Production Date Hydro Date Last Serviced 0, ow P ON Serviced By: 0 a ea Item Inspected PullStation ........................... ............................... Gas Valve / Electrical Cut off .. ..............................,{( Nozzle Location/Appliance Coverage ................. LC7' TankHydro ........................... ............................... Tank..................................... ............................... ControlHead ........................ ............................... r !r Braketing .......................... _% . . ................. u Fuse Links - Replaced or Gleaned! .................. a- Systems Installed to Mfctr's Recommendations.. E 1" Fdter ..................................... ............................... Failures & Recommendations: r ' ©' F1 El i Exhaust Fan .......................... ............................... y /6 Make up Air .......................... ............................... [I' El 1:1 r` i! g l/ Q UL 300 .................................. ............................... f-3) Filters - Baffle Style .............. ............................... K- Class ................................. ............................... 1 e T aC D i ff 9 " ( w Detection Line ...................... ............................... Et V lamSystemMonitoredBy: Yes No , The signature below assures that the above stated services have been rendered accordingly. I have PH # been given authority to allow and approve payment for such required services by the establishment which has received this service and hereby authorized payment for all services rendered. Hood & Duct ........................ ............................... Other..................................... ............................... of eServiceserformedriorto30daY• xnir tinn Ot her ..................................... ............................... 1:1 E] El SPP Signature Nozzle 4M Links Hood Size Date' Payment due upon completion. Pd d 10- 6F t G Type Appl _ '/Type Appl Type Appl Type Appl Type Appl Distance Distance Distance Distance Distance Nozzle V Nozzle ? R .) t rNozzle 0't r-), 0,. ozzle Nozzle _ Type App] Distance Nozzle ea Item Inspected PullStation ........................... ............................... Gas Valve / Electrical Cutoff .. ..............................,{( Nozzle Location/Appliance Coverage ................. LC7' TankHydro ........................... ............................... Tank..................................... ............................... ControlHead ........................ ............................... r !r Braketing .......................... _% . . ................. u Fuse Links - Replaced or Gleaned! .................. a- Systems Installed to Mfctr's Recommendations.. E 1" Fdter ..................................... ............................... Failures & Recommendations: r ' ©' F1 El i Exhaust Fan .......................... ............................... y /6 Make up Air .......................... ............................... [I' El 1:1 r` i! g l/ Q UL 300 .................................. ............................... f-3) Filters - Baffle Style .............. ............................... K- Class ................................. ............................... 1 e T aC D i ff 9 " ( w Detection Line ...................... ............................... Et V lamSystemMonitoredBy: Yes No , The signature below assures that the above stated services have been rendered accordingly. I have PH # been given authority to allow and approve payment for such required services by the establishment which has received this service and hereby authorized payment for all services rendered. Hood & Duct ........................ ............................... Other..................................... ............................... of eServiceserformedriorto30daY• xnir tinn Other ..................................... ............................... 1:1 E] El SPP Signature Nozzle 4M Links Hood Size Date' Payment due upon completion. Pd d 10- 6F t G Type Appl _ '/Type Appl Type Appl Type Appl Type Appl Distance Distance Distance Distance Distance Nozzle V Nozzle ? R .) t rNozzle 0't r-), 0,. ozzle Nozzle _ Type App] Distance Nozzle P P Signature Nozzle 4M Links Hood Size Date' Payment due upon completion. Pd d 10- 6F t G Type Appl _ '/Type Appl Type Appl Type Appl Type Appl Distance Distance Distance Distance Distance Nozzle V Nozzle ? R .) t rNozzle 0't r-), 0,. ozzle Nozzle _ Type App] Distance Nozzle Distance Distance Distance Distance Distance Nozzle V Nozzle ? R .) t rNozzle 0't r-), 0,. ozzle Nozzle _ Type App] Distance Nozzle